• Title/Summary/Keyword: femur fracture

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Outcomes of Treatment for Pathologic Fractures Secondary to Simple Bone Cyst (장관골 단순성 골낭종에 동반된 병적 골절의 치료결과)

  • Jeon, Si-Hyun;Song, Kwang-Soon;Kim, Chul-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.38-44
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    • 2003
  • Purpose: To suggest an appropriate treatment modality regarding analyze outcomes of treatment for pathologic fracture to simple bone cyst of the long bone. Materials and Methods: We selected 12 cases with pathologic fracture of the long bone among the 31 cases treated for simple bone cyst from December. 1993 to May. 2001. The mean age was 9 years ranged from 2 years to 19 years, male was 11 cases and female was 1 cases, and the mean follow up interval was 32.9 month ranged from 12 month to 69 month. The principle of treatment for pathologic fracture of the long bone was conservative treatment except operative treatment for fracture with displacement of the femur. After fracture was united, the residual lesion was treated by local steroid injection, cortical drilling, curettage & bone graft. But we observed without specific treatment in cases that had healing process of simple bone cyst followed by bony union. The clinical results were evaluated as exellent if simple bone cyst was completely healed, as good if that had process of healing, as poor if that was no change or more increased in size. Results: The pathologic fracture was united in all cases treated with conservative treatment in 9cases and by open reduction with internal fixation in 3 cases. After fracture was united, the 6 cases were observed without specific treatment, because they had healing process of cyst, and had outcomes as good and excellent. Conclusion: We suggest to need observation when simple bone cyst has healing process after pathologic fracture was united, otherwise secondary treatment will be needed when residual lesion is persisted.

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A dosimetric evaluation of volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy for the lower extremity soft tissue sarcoma (하지 연부조직육종을 위한 방사선치료기술 별 선량평가 연구)

  • Lee, SolMin;Song, Seongchan;Hyun, Sung Eun;Park, Heung Deuk;Lee, Jaegi;Kim, Young Suk;Kim, Gwi Eon
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.1-5
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    • 2016
  • A dosimetric evaluation of volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy for the lower extremity soft tissue sarcoma For the lower extremity soft tissue sarcoma, volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy were evaluated to compare these three treatment planning technique. The mean doses to the planning target volume and the femur were calculated to evaluate target coverage and the risk of bone fracture during radiation therapy. Volumetric modulated arc therapy can reduce the dose to the femur without compromising target coverage and reduce the treatment time compared with intensity modulated radiation therapy.

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Functional and Radiological Results of Intermediate-term Follow Up in $MUTARS^{(R)}$ Tumor Endoprostheses ($MUTARS^{(R)}$ 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 중기 추시 결과)

  • Kang, Dong-Joon;Kim, Jeung-Il;Oh, Jong-Seok;Moon, Tae-Yong;Lee, In-Sook
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.36-43
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    • 2011
  • Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.

Analysis on Femoral Neck Fractures Using Morphological Variations (파라메트릭 형상모델을 이용한 근위 대퇴골의 경부 골절 영향 해석)

  • Lee, Ho-Sang;Park, Byoung-Keon;Chae, Je-Wook;Kim, Jay-Jung
    • Journal of the Korean Society for Nondestructive Testing
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    • v.31 no.5
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    • pp.459-465
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    • 2011
  • It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF.

Rutin Improves Bone Histomorphometric Values by Reduction of Osteoclastic Activity in Osteoporosis Mouse Model Induced by Bilateral Ovariectomy

  • Lee, Hye-Hwa;Jang, Jae-Won;Lee, Jung-Kil;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.433-443
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    • 2020
  • Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

Genome-Wide Association Study of Bone Mineral Density in Korean Men

  • Bae, Ye Seul;Im, Sun-Wha;Kang, Mi So;Kim, Jin Hee;Lee, Soon Hang;Cho, Be Long;Park, Jin Ho;Nam, You-Seon;Son, Ho-Young;Yang, San Deok;Sung, Joohon;Oh, Kwang Ho;Yun, Jae Moon;Kim, Jong Il
    • Genomics & Informatics
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    • v.14 no.2
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    • pp.62-68
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    • 2016
  • Osteoporosis is a medical condition of global concern, with increasing incidence in both sexes. Bone mineral density (BMD), a highly heritable trait, has been proven a useful diagnostic factor in predicting fracture. Because medical information is lacking about male osteoporotic genetics, we conducted a genome-wide association study of BMD in Korean men. With 1,176 participants, we analyzed 4,414,664 single nucleotide polymorphisms (SNPs) after genomic imputation, and identified five SNPs and three loci correlated with bone density and strength. Multivariate linear regression models were applied to adjust for age and body mass index interference. Rs17124500 ($p=6.42{\times}10^{-7}$), rs34594869 ($p=6.53{\times}10^{-7}$) and rs17124504 ($p=6.53{\times}10^{-7}$) in 14q31.3 and rs140155614 ($p=8.64{\times}10^{-7}$) in 15q25.1 were significantly associated with lumbar spine BMD (LS-BMD), while rs111822233 ($p=6.35{\times}10^{-7}$) was linked with the femur total BMD (FT-BMD). Additionally, we analyzed the relationship between BMD and five genes previously identified in Korean men. Rs61382873 (p = 0.0009) in LRP5, rs9567003 (p = 0.0033) in TNFSF11 and rs9935828 (p = 0.0248) in FOXL1 were observed for LS-BMD. Furthermore, rs33997547 (p = 0.0057) in ZBTB and rs1664496 (p = 0.0012) in MEF2C were found to influence FT-BMD and rs61769193 (p = 0.0114) in ZBTB to influence femur neck BMD. We identified five SNPs and three genomic regions, associated with BMD. The significance of our results lies in the discovery of new loci, while also affirming a previously significant locus, as potential osteoporotic factors in the Korean male population.

Bone Segmentation Method based on Multi-Resolution using Iterative Segmentation and Registration in 3D Magnetic Resonance Image (3차원 무릎 자기공명영상 내에서 영역화와 정합 기법을 반복적으로 이용한 다중 해상도 기반의 뼈 영역화 기법)

  • Park, Sang-Hyun;Lee, Soo-Chan;Yun, Il-Dong;Lee, Sang-Uk
    • Journal of Broadcast Engineering
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    • v.17 no.1
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    • pp.73-80
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    • 2012
  • Recently, medical equipments are developed and used for diagnosis or studies. In addition, demand of techniques which automatically deal with three dimensional medical images obtained from the medical equipments is growing. One of the techniques is automatic bone segmentation which is expected to enhance the diagnosis efficiency of osteoporosis, fracture, and other bone diseases. Although various researches have been proposed to solve it, they are unable to be used in practice since a size of the medical data is large and there are many low contrast boundaries with other tissues. In this paper, we present a fast and accurate automatic framework for bone segmentation based on multi-resolutions. On a low resolution step, a position of the bone is roughly detected using constrained branch and mincut which find the optimal template from the training set. Then, the segmentation and the registration are iteratively conducted on the multiple resolutions. To evaluate the performance of the proposed method, we make an experiment with femur and tibia from 50 test knee magnetic resonance images using 100 training set. The proposed method outperformed the constrained branch and mincut in aspect of segmentation accuracy and implementation time.

Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density (골다공증 진단을 위한 초음파 변수의 골밀도에 대한 의존성)

  • Hwang, Kyo Seung;Kim, Yoon Mi;Park, Jong Chan;Choi, Min Joo;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.502-508
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    • 2012
  • Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

Effects of Cuscutae Semen Extract on Prevention of Osteoporosis in Ovariectomized Rats (토사자(兎絲子)가 난소적출(卵巢摘出)로 유도(誘導)된 흰쥐의 골다공증(骨多孔症)에 미치는 영향(影響))

  • Kim, Jong-Hyun;Kim, Ho-Seok;Jun, Jae-Yun;Jeong, Da-Won;Cho, Chang-Young;Sohn, Young-Joo;Jung, Hyuk-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.4
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    • pp.1-11
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    • 2012
  • Objectives: Osteoporosis, which occurs after menopause, is a kind of metabolic bone disorder. It develops when the bone mass begins to decrease radically, and its main symptoms are bone fracture and height-shortening. This thesis aims at what effects the Cuscutae Semen Extract(CSE) has on the prevention of osteoporosis in SD-rat that is caused by ovariectomy. Methods: The 24 female white rats, after removing their ovaries, were divided into the Normals, the Control group, and the CSE administrated group. For the next 8 weeks, distilled water to the normals and the control, and the CSE(45.9 mg/100 g) to the CSE administrated group were given in the mouths of them. After 8 weeks the rats were sacrificed. Weight, albumin, aspartate aminotransferase, alanine aminotransferase, total-cholesterol, triglyceride, phosphorus, calcium, tetraiodothyronine, estradiol, the weight of the femur, the amount of tibia ash, the area of trabecular bone, and the thickness of trabecular bone were measured. Results: The serum analysis shows that the calcium and phosphorous of the CSE administrated group significantly increased compared to that of the control group. Aspartate aminotransferase, alkalinephosphatase, total cholesterol, tetraiodothyronine of CSE group were decreased, but not so significant. Albumin, alanine aminotransferase, triglyceride and estradiol of the group showed the tendency to increase, but the significance wasn't admitted. Regarding the variation of bone, the femur weight and the ash content of tibia, CSE group was more increased than the control group but the significance wasn't admitted. The histological observation shows that the trabecular thickness was more increased than the control group, and trabecular area increased significantly compared to those of the control group. The number of osteoclast and osteoblast area of the CSE groups decreased significantly compared to those of the control group. Conclusions: From the result of the above study, CSE should be effective for the osteoporosis cure and precaution and deeper study through bedside and clinical demonstration is much needed from now on.